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MS can cause pain, itching, and a number of other symptoms affecting the skin.

Alamy

Virtually all symptoms of multiple sclerosis (MS) are a result of the damage MS does to the brain and spinal cord.

That includes symptoms that involve the skin, such as numbness, tingling, pain, and itching, as well as “phantom” sensations, which have been described as a feeling of insects crawling, water dripping, wetness, pressure, and vibration in particular areas of the body.

According to Jacqueline Nicholas, MD, MPH, a neuroimmunologist at OhioHealth Multiple Sclerosis Center in Columbus, Ohio, “The brain and spinal cord are the supercomputer for our entire body, so when there’s disruption of certain areas of the brain or spinal cord that control sensation, this can cause someone to lose sensation on the skin completely, or leave a painful sensation called dysesthesia.”

While there’s no single, sure-fire treatment for MS-related skin problems, “If an individual with MS is having any painful skin sensation or other skin problems, he should feel empowered to talk to his care team about them, because we can intervene and help to limit these complications,” says Dr. Nicholas.

“The goal with MS is to live as normal a life as possible. And in relation to skin problems, we want to make them as least annoying and as tolerable as possible,” Nicholas says.

Skin Pain Caused by MS

The sensation of burning pain caused by MS can occur anywhere on the body but is particularly common on the legs and tends to be a constant pain. The legs can also be sensitive to the touch and feel cold.

Brad Mann, who formerly blogged for Everyday Health, has progressive relapsing MS and says he experiences uncomfortable skin sensations daily, including painful numbness in his fingertips and feet.

“I believe this is often the reason that I unexpectedly drop things. There has not been an easy fix or solution to this problem,” says Mann.

“Normally, if our brain is firing off a signal that isn’t something that should be occurring, we have an inhibitory neuron signal, but when there’s damage, the inhibition may be lost. That’s why people can have these painful sensations that are occurring even if they don’t move or do anything,” Nicholas says.

Antidepressants such as Pamelor (nortriptyline), Elavil (amitriptyline), and Cymbalta (duloxetine). These drugs can also cause drowsiness.

Lidocaine patches (used to treat severe pain in a localized area). Nicholas warns that most insurance companies cover one patch a day, and since the patches are small, that is usually not enough to treat a large area of pain.

Capsaicin cream, which can cause temporary burning or stinging where applied but which can, over time, block painful sensations.

If none of these drugs adequately controls the pain, a pain specialist may need to be involved in the care team to offer other alternatives.

Itching Associated With MS

When MS causes an itchy feeling, there is generally no sign of irritation on the skin such as a rash or bug bite.

“You might think ‘I have an itch. It must be dry skin,’ but if there is severe damage on the spinal cord or brain stem which controls sensation to that area of the body, that could be the cause of the itching,” says Nicholas.

Mann can attest to this.

“It’s a type of itching you might feel after an insect sting or if you were out in the cold too long, and sensation’s just starting to come back. It’s that stinging, burning type of itching that steadily increases in severity until it becomes impossible to ignore,” he says.

Topical skin creams are often not helpful with MS-related itching. However, Nicholas says there are that can be helpful, such as antiepileptic medications, Lidocaine patches, and possibly antihistamines (although they are sedating). However, this is a difficult symptom to treat, she notes.

Phantom Sensations

Mann also experiences the unpleasant sensation of insects crawling on his body, referred to as a “phantom sensation.”

“It’s as if they’re creeping up my legs and under my shirt and throughout my hair. It’s such a realistic feeling that I often have to look in the mirror just to double check that it’s not actually happening,” he says.

Managing the discomfort of his various symptoms is a challenge for Mann. While anticonvulsant medications provide some relief, he uses other strategies to help, such as applying ice and heat to areas of his body and using electrodes on the nerve receptors to distract his body from painful sensations.

“These strategies are developed over time, solely through trial and error with approval from my physician,” Mann says. “I find that the best thing to do is to try to distract my body from its strange sensations by overloading it with other sensations. So if I’m experiencing uncomfortable skin sensations, then I provide it with even more discomfort. It’s like fighting fire with fire.”